Venezuela: Cuban doctors defect, speak out on Barrio Adentro

By Steven Dudley

CARTAGENA, Colombia 22 August 2006 - Carlos Rodriguez and his girlfriend, Johan Mary Jimenez, had little hope of leaving Cuba. They were both physicians, her father was a known dissident, and Rodriguez himself was an outspoken critic of the system.

Still, in May 2004, a Cuban government seemingly desperate to satisfy Venezuela's need for doctors slotted the two into Mision Barrio Adentro, President Hugo Chavez's campaign to provide healthcare for his country's poorest people.

They fled to Colombia seven months later and obtained political asylum. They are now scratching out a living doing odd jobs near this Caribbean city - and offering insights into the Cuban doctors program in Venezuela.

Since taking power in 1999, Chavez has increased trade with Cuba and sought to benefit from its expertise in health, education and defense. Barrio Adentro, or ''Inside the Neighborhoods,'' was one of several programs Chavez set up with the help of Cubans, and an estimated 20,000 Cuban medical personnel are working in Venezuela.

Many of these Cubans wind up defecting. Exact numbers are impossible to get, but Julio Cesar Alfonso of the Miami-based Solidarity without Borders, a group that helps Cuban doctors abroad who defect, estimates that more than 500 have escaped the programs in many countries.

Cuban doctors working abroad do not have an easy life.

Cuban officials monitor them closely, Rodriguez and Jimenez told The Miami Herald. They could not speak with the media, and there were regular ''code reds'' - alerts for unspecified reasons during which they couldn't leave home.

Rodriguez, 30, and Jimenez, 28, were working in the town of Lagunillas, near Venezuela's northwestern border with Colombia. Like many Cuban medical personnel, they went to Venezuela with the hope of saving a little money, or at least returning home with some consumer goods hard to find on the island.

''Cubans look for a way to change their lives,'' Rodriguez said. "Going to another country to work was one way to do that."

Venezuela turned out to offer few benefits, however.

The couple said they each received the equivalent of about $200 a month as salary. The Venezuelan government provided them with separate housing and the state oil company, PDVSA, subsidized their food.

But money was still tight because of Venezuela's high cost of living, they said, and other doctors did not even receive the PDVSA food subsidy.

Barrio Adentro was also disappointing, they said.

Although it was promoted as a way to help poor people who had minor illnesses, aches, pains and infections, Rodriguez and Jimenez said their Cuban supervisor made it clear that they also had to campaign for Chavez in the lead up to a 2004 recall referendum, which Chavez won handily.

''The idea is good,'' Rodriguez said of the mission. "But that wasn't what the mission was for. The coordinator told us that our job was to keep Chavez in power."

The coordinator also required the doctors to put up Chavez posters in the small clinics they established in poor barrios, and told them to tell patients "to vote for Chavez."

''I wouldn't do it,'' Rodriguez added. "I told them that I was happy to do the work as a doctor, but I won't campaign."

Not all of the barrio residents were sympathetic to the Cubans. Anti-Chavez neighbors called them ''Fidel's ambassadors'' and refused to go to their clinics, the couple said.

The Cuban medical personnel also provided the Venezuelans with Cuban medicines. Rodriguez, who was part of the team that distributed the medicine to neighborhoods, said ''boxes and boxes and boxes'' arrived weekly from Cuba via military aircraft.

Whether Cuba donated the medicines, or the Venezuelan government paid for them, was impossible to establish.

Since the Venezuelan program was launched, Cubans on the island have complained about a significant drop in the number of doctors there and the already low supplies of medicines there.

"I was worried about all this medicine leaving Cuba," Jimenez said. "What about the Cubans?"

In the past, Chavez has alluded to the medical program as a swap of Cuba's human resources for Venezuela's natural resources - mostly oil - and part of his campaign to strengthen relations with Latin American nations and distance them from the United States.

Cuba, for instance, receives upwards of 90,000 barrels a day of crude oil from Venezuela on easy repayment terms. Most nations that host Cuban medical personnel also make per-doctor cash payments directly to the Cuban government, but it's not clear whether Venezuela is making such payments or writing off the amounts against its oil deliveries.

Neither Venezuela nor Cuba has provided any public accounting of the costs for their Cuban doctors arrangement, but a recent Bush administration report estimated Venezuelan energy subsidies to Cuba at $1 billion.

For Rodriguez and Jimenez, the best part of their deployment to Venezuela was that it offered them an escape hatch.

They met with a Colombian friend of another doctor, who arranged for them to cross the Colombian border in a car for about $50. They left in the early morning hours of Dec. 11. By noon, they were in Cartagena.